Surgery for some types of mesothelioma might be done either to try to cure the cancer or to relieve symptoms.
To attempt a cure, major surgery might be needed. This might be done if the person is in good health (other than the cancer) and if it seems as if the tumor is only in one place. While in most cases surgery is not likely to cure the cancer, it might extend the person’s life.
But in most cases the cancer has spread to other places before it is found. Surgery to relieve symptoms (called palliative surgery) is often done in cases where the tumor has already spread or when the person is too sick to go through more involved surgery.
If your doctor recommends surgery, ask for more details about the operation and what the goal is.
Surgery for pleural mesothelioma
There are 3 types of surgery that could be used if you have mesothelioma in the linings of the lungs.
One is a bigger operation that attempts to remove all or most of the cancer and some of the tissues around it, including the nearby lung. (This surgery is called an extrapleural pneumonectomy or EPP.) This is a complex operation and is done only by surgeons in large medical centers. You must be in good overall health with good lung function and no other serious illnesses in order to have this surgery.
Another type of surgery is called a pleurectomy/decortication or P/D. This smaller operation may be done to try to cure some cancers, but it is more often used to relieve symptoms in cases where the whole tumor cannot be removed. It can help control the build-up of fluid, improve breathing, and decrease pain caused by the cancer.
An even smaller surgery called debulking might be done to remove as much of the mesothelioma as possible.
Possible side effects of surgery: Possible risks and side effects depend on the extent of the surgery and the person’s health beforehand. Serious complications of EPP can include bleeding, blood clots, wound infections, changes in heart rhythm, pneumonia, and loss of lung function. Because the surgeon must often spread the ribs during surgery, the incision will hurt for some time afterward. Your activity will be limited for at least a month or two.
Surgery for peritoneal mesothelioma
These tumors are often too advanced to be removed completely. The goal of this surgery is usually to relieve or prevent symptoms, instead of trying to cure the cancer.
Debulking might be done to remove as much of the mesothelioma as possible. Sometimes this means removing pieces of the intestine.
The omentum is an apron-like layer of fatty tissue that drapes over the contents of the abdomen. Cancers involving the peritoneum often spread to this tissue, so it may be removed as part of surgery.
Surgery for pericardial mesothelioma
Operations can be done to remove a mesothelioma from the pericardium (the sac around the heart).
Surgery for mesothelioma of the tunica vaginalis testis
Surgery for these mesotheliomas, which occur in the groin, rarely cures this cancer. Most of the time surgery is done because the tumor is thought to be a hernia at first. The surgeon attempts to treat the suspected hernia and only learns that it is cancer after the surgery is begun. This kind of mesothelioma typically can’t be removed entirely.
Other ways to relieve symptoms
In many cases, surgery may not be a good option, even to relieve symptoms. Other, less invasive treatments may be used instead. While these methods can relieve symptoms, they are not meant to cure the cancer.
Fluid in the chest, abdomen, or around the heart can be removed by putting a hollow needle into the fluid and drawing it out. In the chest, sometimes talc or drugs are then put in to cause the linings of the lung and chest wall to stick together, sealing the space to help keep fluid from building up again. No matter where the fluid is, numbing medicine is used on the skin before the needle is put in. This may be done in a doctor’s office or in the hospital.
If fluid keeps coming back in the chest, a shunt might be put in. A shunt is a device that allows fluid to move from one part of the body to another. The shunt is a long, thin tube with a small pump in the middle. In the operating room, the doctor puts one end of the shunt into the chest and the other end into the abdomen (belly). Once the shunt is in place, the patient uses the pump (which is just under the skin) several times a day to move the fluid from the chest to the abdomen, where it is more likely to be absorbed by the body.
Another approach sometimes used to control the build-up of fluid is a catheter – a thin flexible tube. One end of the catheter is put in the chest or abdomen and the other end is left outside the body. This is done in a doctor’s office or hospital. Once in place, the catheter can be attached to a special bottle or other device to allow the fluid to drain out.
For more information about surgery, please see our document, Understanding Cancer Surgery: A Guide for Patients and Families.
Last Revised: 10/02/2012